During the 1970s, the U.S. began what has now become known as the “war on drugs,” a reaction to the counterculture and drug-fueled climate of the 1960s. To the government’s dismay, these policies did nothing to quell the use of illicit drugs; rather, it opened a huge market for the illegal development, distribution and importation of psychoactive and hallucinogenic substances like marijuana, cocaine, LSD and, later, ecstasy and designer drugs.

Forty years later, the U.S. is facing a very different problem—a nation addicted to prescription drugs. And to make things a bit more complex, some of these illicit “street drugs” are now being hailed as potential breakthrough therapies for depression, post-traumatic stress disorder, and possibly even autism. With the FDA's recent decision to designate MDMA (also known as ecstasy) as a breakthrough therapy for PTSD, the increasingly blurred lines between prescription and illicit drugs in the U.S. and their impact on health and society are becoming even more complex.

As a graduate fellow at Boston University, I helped teach an introductory course on physiological psychology. I began our section on the effects of psychoactive substances on the nervous system by revealing to my students that all bioactive substances—from caffeine to diet pills to cocaine—should be labeled as drugs, regardless of their legal status. I was met with blinking, vacant stares. Surely this perspective is not earth-shattering and most people agree that, yes, a drug is a drug no matter what label it maybe attached to.

But from a sociocultural perspective, different types of drug use are associated with different, harmful stereotypes. For example, a homeless person who uses heroin is a “menace” to society but a mom recovering from back surgery who uses opioids for pain relief is just taking medicine her doctor prescribed. These problematic stereotypes have been ingrained into our culture, creating a dichotomous framework by which people understand drug use; taking (and even abusing) prescription drugs is okay because a doctor gave them to you but taking (or abusing) illicit drugs is not okay because decades ago they were placed into the illegal category.

And so herein lies our society’s strange relationship to bioactive substances. Our biggest problem now lies in addressing addiction to prescription drugs, while therapeutic uses for illicit drugs are coming to light. Perhaps the greatest frustration is for those parents whose children respond only to medical cannabis to treat their epilepsy. Although there have been recent sweeping changes across the country with respect to medical cannabis regulation, and even legalized recreational use, there remains incredible confusion surrounding the legal use and transport of this semi-legalized substance.

Until there is both political and cultural alignment on how we approach the education of bioactive substances—what they are, what they do, and their benefits and risks—we will remain a confused and frustrated society, grasping at bits of information, or misinformation, from reliable or unreliable sources. And while many of these substances hang in the balance between legal and illegal status, we must challenge their restricted use with rigorous scientific evidence. Of course, every bioactive substance must be tested and approved by the FDA to ensure its dosing, safety and effectiveness for the intended population—but these studies require funding and support from federal resources, which they are very much lacking.

This issue can no longer be caught in a web of confusing regulations. Pioneering researchers are breaking through barriers, whether we are ready for it or not. And legislators are going to need to make decisions on these regulations sooner than they may be prepared to, starting on alignment with the FDA.

We can only hope that within the next decade the effects of the “war on drugs” will start to fade and give way to a more comprehensive and fact-based understanding of all bioactive substances. So whether you reach for the medicine bottle or the lighter, you’ll understand just how each dose will affect you, the benefits and risks of consumption, and the potential for abuse—and, however you choose to use these substances, you’ll have greater assistance from our health care system and a more open-minded society to support your choices.

The views expressed are those of the author(s) and are not necessarily those of Scientific American.

ABOUT THE AUTHOR(S)

Loren DeVito

Loren DeVito, PhD, is a trained neuroscientist and science writer. In addition to publishing several academic articles on cognition and memory, Loren has also written for The Michael J. Fox Foundation, Medical News Today, and others. She currently owns and operates Sticky Ink, Inc., which provides science and medical writing and strategic services for the pharmaceutical, non-profit, and health care industries.

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